Bring your lived experience to Yooralla – Join YCPAC

Expression of interest form

We are seeking expressions of interest to join YCPAC from:

Yooralla clients and/or their family members – three vacancies

Members of Victorian disability community (i.e. who are not Yooralla clients or family members) – two vacancies.
If you (or someone you know) are committed to the provision of quality, safe and accessible support services for people with disability, please consider applying.

Applications close on 27 September 2023.

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* 1. Name

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* 2. Your email address

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* 3. Date of birth

Day/Month/Year

Date

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* 4. Preferred pronouns

She/Her

He/Him

They/Them

Other (please specify)

Bring your lived experience to Yooralla – Join YCPAC

Expression of interest form

Question Title

* 1. Name

Question Title

* 2. Your email address

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* 3. Date of birth

Question Title

* 4. Preferred pronouns

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* 5. Best contact phone number

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* 6. Please tell us a bit about yourself and your lived experience of disability

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* 7. Why would you like the join this Advisory Committee

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* 8. What knowledge and skills do you bring to the role of representing the issues, needs and wants of people with disability?

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* 9. What are your areas of interest in regards to your participation?

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* 10. Are you currently receiving a service provided by Yooralla? If so, which one/s?

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* 11. What is your country of birth

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* 12. Is English your first language?

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* 13. What, if any, support do you need to help you to participate?